Christine Ellis, LLC
Organization Active NPI Community/Behavioral Health Agency · Sioux Falls, SD
NPI 1962608570 · NPPES record last updated Jul 1, 2011
Key facts
- NPI
- 1962608570
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 1936 (SD)
- Legal business name
- CHRISTINE ELLIS, LLC
- Practice address
- 5000 S Minnesota Ave
Suite 200
Sioux Falls, SD 57108-2707 - Phone
- (605) 271-1348
- NPI assigned
- Jun 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Christine Elizabeth Ellis, CSW-PIP
- Title
- Clinical Social Worker
- Phone
- (605) 271-1348
Practitioners 1
-
Christine Elizabeth Ellis, CSW-PIP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071127000032 | SD | Part B Supplier - Clinic/Group Practice | 6507954658 |
Receives reassigned benefits from 1 practitioner Practice locations: Sioux Falls, SD |
National Provider Directory
Locations
5000 S Minnesota Ave
Ste 200
Sioux Falls, SD 57108
Phone (605) 271-1348
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 1936 | SD | Yes |
| Community/Behavioral Health Agency | 251S00000X | 06783 | IA | |
| Community/Behavioral Health Agency | 251S00000X | 18354 | MN |
Addresses
Primary practice location
5000 S Minnesota Ave
Suite 200
Sioux Falls, SD 57108-2707
Mailing address
5000 S Minnesota Ave
Suite 200
Sioux Falls, SD 57108-2707
Phone (605) 271-1348
Other providers in Sioux Falls, SD
- Sarah Renea Christenson
- Christian Family Care, LLC
- Erin Christian
- Brenna J Christiansen
- David C Christianson
- Helen Christopherson
- Rachel Christopherson
- Thomas J Christopherson
- Stan Christopherson120245
- Lorayne Ann Chua
All providers in Sioux Falls, SD · Community/Behavioral Health Agency in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.